Harber ML. Pharmacy Trends, Litigation, and Legislation. HRProfessionalsMagazine. https://hrprofessionalsmagazine.com/2020/07/31/pharmacy-trends-litigation-and-legislation/. Published August 3, 2020.
Employer-sponsored health and pharmacy plans continue to experience rising costs in their drug expenditures. During these times of economic slowdown, financial uncertainty, and a greater focus on expense control, employers have an opportunity to look at different ways to manage drug spend. There are some good examples of employers in Mississippi and in the Southeast working to reduce the waste and unnecessary cost and also promoting good patient consumerism. However, more employers need to step up and take more meaningful action by identifying key levers and moving to value-based benefit designs which reduce barriers to high valued services, products, and programs.
Employer-sponsored health plans have worked with Pharmacy Benefit Managers (PBMs) over many years to process claims between the pharmacy and the plan. They have been around since the early 70’s and 80’s and have grown to doing more than their initial intention. These additional efforts have caused friction with the local and independent pharmacies as they usually must pay a higher price due to contracting and volume differences. Also, PBMs offer programs that steer plan members to specific pharmacies and to mail-order programs which also causes friction with local pharmacies. These programs are promoted as cost savings to the plans and their members and have worked to improve compliance and cost. With all this friction, it is important that employers begin to work with proven transparent PBM’s who share data and assist with looking at ways to improve value of the investments into these benefits plans.
Read the full article here https://hrprofessionalsmagazine.com/2020/07/31/pharmacy-trends-litigation-and-legislation/